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Understanding Secondary Trauma For Mental Health Professionals

Posted on: October 24, 2022

In the professional world, there are many careers that take an emotional toll on those that pursue them. From mental health professionals to social workers to first responders, these are the people on the frontline of witnessing or learning about emotional trauma. This can lead to secondary trauma.

As the emotional pillars of our society, they, too, can need support for their mental well-being. Secondary trauma isn’t a straightforward concern for many whose calling leads them to help people as a career. However, to create a sustainable career that doesn’t snowball into emotional exhaustion or high turnover, understanding secondary trauma and who’s most at risk is critical.

Below we will outline what is secondary trauma, why it matters and where to find important resources for professionals.

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What is secondary trauma?

Secondary trauma, also known as secondary traumatic stress, compassion fatigue and vicarious trauma, takes place when a person interacts with or observes another person’s traumatic experience. These moments of trauma are not limited to emotional suffering — they may also include events that led to physical pain and injury.

Secondary trauma may occur due to one specific account; for example, if a first responder hears a particularly harrowing story of trauma from a patient. However, it can also occur over a period of time due to the cumulative psychological toll of hearing about a trauma survivor’s firsthand experience on a daily or weekly basis. This is often the case for mental health professionals and social workers.

Some events that may lead to secondary trauma include:

  • Listening to or learning about distressing trauma experiences.
  • Caring for or treating those with intense physical injuries.
  • Bearing witness to survivors’ physical or emotional distress.

By listening and offering support, these professionals are susceptible to developing indirect trauma from the stress and content of survivor stories. This may affect their ability to effectively complete their occupational duties and cause undue pressure on their personal mental health.

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What is the difference between secondary trauma and burnout?

It’s important not to conflate secondary trauma and burnout with each other. One can experience both, but burnout doesn’t equal secondary trauma.

Although they sometimes display similar symptoms, secondary trauma is directly due to supporting and listening to trauma victims. On the other hand, burnout may arise due to a broad range of reasons — and it can occur across any occupation. Most commonly, employees experience burnout due to undue workplace stress and workload.

A common example of burnout is when an office worker struggles with low to no job satisfaction and an inordinate workload. This overwhelms the worker’s mental health and causes many similar symptoms to secondary trauma. Yet, these symptoms are due to the worker’s firsthand negative experience at their job.

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What are the common symptoms of secondary trauma?

To determine whether someone is experiencing secondary trauma, it’s essential to recognize the most common symptoms. Although, it’s important to note that the person struggling with secondary trauma may not show all symptoms listed in this guide.

Due to compassion fatigue, symptoms may include any of the following:

  • Chronic exhaustion
  • Apathy
  • Depression
  • Feelings of helplessness
  • Intrusive thoughts or imagery
  • Persistent negativity
  • Cynicism
  • Feelings of guilt or fear
  • Dissociation
  • Inability to empathize with victims
  • Loss of interest in their chosen field
  • Inability to focus or listen
  • Addictions (e.g., drinking, substance use, etc.)
  • Appetite changes
  • Difficulty sleeping
  • Rigid thinking

This list doesn’t include every possible symptom of secondary trauma. Those experiencing compassion fatigue may show other signs.

These symptoms often lead to high attrition in fields of work that deal regularly with trauma victims. This can make it hard to retain employees in careers that involve heavy emotional labor. They also can affect the ability of professionals to do their jobs effectively long-term.

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Who is at risk of secondary trauma?

Human services professionals and mental health clinicians are most at risk of developing secondary traumatic stress. These are the people who directly work with traumatized individuals on a day-to-day basis. As they support and care for trauma victims, the psychological toll leads to its own form of trauma.

Below are fields that can often lead to secondary trauma:

Mental health professionals

This is the most common field associated with secondary trauma. The actual job entails listening to and offering support to those that have experienced trauma. If a mental health professional, such as a therapist or psychologist, doesn’t take adequate time to evaluate their own emotional well-being and needs, this can impact their ability to care for others.

Emergency medical services (EMS)

As the name suggests, emergency medical services put workers in direct contact with those suffering from physical pain and/or injuries. This includes first responders, emergency room (ER) doctors and nurses, palliative care nurses and others in the medical field. These distressing experiences can severely impact the mental health of those in EMS.

Police officers and emergency personnel

Police officers, dispatchers, firefighters and those in law enforcement offices all experience psychological and emotional impacts due to their careers. This field can be extremely stressful due to the combative and emotional nature of law enforcement and emergency protective services. In the field, professionals may also witness gruesome injuries and distress.

A great resource to understand the full impacts of secondary stress in this field is Stephanie M. Conn’s Increasing Resilience in Police and Emergency Personnel: Strengthening Your Mental Armor. With experience as a clinician, researcher and former police officer, the author breaks down how those in this career field may struggle with resulting traumatic stress. From police officers to administrators to family members, this helpful guide offers real-world anecdotes and exercises to provide support.

Important note: This is not a comprehensive list of every field that may be impacted by secondary trauma. Similarly, some secondary trauma sufferers may experience symptoms due to a one-time circumstance or series of moments.

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What are secondary trauma treatment options?

As airlines often remind flyers, it’s important to put on your own oxygen mask before helping someone else. When people join fields that deal directly with helping people, they often come with feelings of hope, passion and empathy for vulnerable groups. However, the cumulative impact of providing support to others’ traumas can build up and lead to secondary trauma.

When secondary trauma begins to form, it negatively impacts people’s ability to care for others because they aren’t caring for themselves. If you’re worried about experiencing secondary trauma and feel any of the symptoms listed in this guide, the American Academy of Pediatrics (AAP) has a few helpful strategies and recommendations:

  • Take time off from work. Exposure to multiple stories of trauma can be hard to process. By taking time off, professionals can take a break from the stress and check in with their families and friends. This may be helpful to allow those with secondary trauma to heal and improve their own mental well-being before returning to work.
  • Share with others. It may be difficult to share about others’ traumatic experiences, but it’s helpful to discuss how they may be affecting you. Sharing these feelings and thoughts with others can be extremely beneficial and help relieve the negative psychological pressure.
  • Take up physical activities. Staying active has enormous physical, emotional and behavioral health benefits. This can help put work experiences into context and create an outlet for emotions.
  • Start a creative endeavor. Journaling, drawing and other creative activities are great methods of reflection and relieving stress.
  • Prioritize relaxation techniques. Yoga is a popular pursuit for a reason — it helps relieve physical symptoms of stress and trauma, as well as emotional turmoil. Similarly, meditation can soothe physical tension and encourage increased positive reflection.
  • Reevaluate why this job matters. Sit down and consider why this is your chosen career. What inspired you to pursue a field in human services? It’s important to remember what led to this path and why it was chosen to begin with.

If secondary trauma is affecting your personal life outside of work, understanding why it happens and what resources exist can help alleviate symptoms. Seeking mental health support is essential. With proper resources, people can discover tools and strategies to improve and sustain their passions.

For leaders in human services, there are also ways to provide employment support for secondary trauma. Some options include:

  • Teaching employees how to identify and manage secondhand trauma.
  • Offering professional support, such as time off and work-life boundaries.
  • Providing helpful resources (e.g., people to reach out to, books, etc.).

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Best books to learn more about secondary trauma from Routledge

Need additional resources for secondary trauma and how to help others? Routledge Mental Health carries a wide variety of books to support those in mental health professions and human services.

Discover industry-leading tools, strategies and resources below:

Beyond Self-Care for Helping Professionals: The Expressive Therapies Continuum and the Life Enrichment Model by Lisa D. Hinz

This professional guide introduces the Life Enrichment Model, which is a strengths-based model that “encourages mindful participation in a broad array of enriching experiences.” The author not only explores how to prevent compassion fatigue but also how to achieve positive psychology and health. Helpful in the field and at home, this book motivates readers to take an active approach to self-care to foster a rich emotional and intellectual life.

Building Resilience Through Contemplative Practice: A Field Manual for Helping Professionals and Volunteers by Bobbi Patterson

The key to a sustainable career in human services is resilience — and this book dives into exactly how professionals and volunteers have been able to cultivate resilience through real-world case studies. It defines the unique phases (stability, collapse, reorganization and exploitation) that occur and the foundations of adaptive resilience theory. Each case study includes tools, skills and exercises to improve how workers prepare for the next steps.

The Compassion Fatigue Workbook: Creative Tools for Transforming Compassion Fatigue and Vicarious Traumatization by Françoise Mathieu

This book is a vital resource for any helping professional that may be suffering from secondary trauma symptoms, such as physical and emotional exhaustion. It clarifies the specific meanings of compassion fatigue and vicarious traumatization to concisely help individuals identify their experiences. It also includes experiential activities to incorporate into a person’s personal and professional life to encourage mental healing. Each reader can utilize the strategies that work best for them to develop their own personalized solution plan.

Inspiration for the Weary Therapist: A Practical Clinical Companion by David Klow

Have you lost inspiration in your field? This book is for the modern practitioner and details the path that can lead to secondary trauma in the mental health field. With Covid-19 rapidly changing the therapy landscape, this book addresses the challenging moments that create their own forms of trauma for mental health professionals. It teaches readers how to prioritize self-care and improve confidence through self-compassion and personal growth.

Reducing Compassion Fatigue, Secondary Traumatic Stress, and Burnout: A Trauma-Sensitive Workbook by William Steele

Created for any helper or organization that aims to provide compassionate care, this workbook explains how to prioritize self-care and improve resilience for those with secondary traumatic stress. The author offers neuro-based and trauma-sensitive recommendations, as well as activities, worksheets and interactive learning tools. Utilize this essential resource to build your own self-care plan.

Reducing Secondary Traumatic Stress: Skills for Sustaining a Career in the Helping Professions by Brian C. Miller

Exposure to trauma for human service professionals is a serious issue and this book was written to reduce potential symptoms. Each chapter provides an evidence-informed strategy to support emotion regulation and mental well-being improvement. It outlines how burnout can affect these workers while also specifically digging into the repercussions of secondary traumatic stress.

Unsure where to start? Access our free sample chapter of Self-Care for Mental Health Professionals here.